Date issued: 01/12/23

Effective January 1, 2023 a new surveillance case definition for multsystem inflammatory syndrome in children (MIS-C) was implemented for reproting cases of MIS-C.

MIS-C is a rare but severe complication in children and young adults infected with SARS-CoV-2 the virus that causes COVID-19.

The new case definition criteria can be viewed at Information for Healthcare Providers about Multisystem Inflammatory Syndrome in Children (MIS-C) CDC.

Key Changes to the Definition:

  • 1. No required duration of subjective or measured fever.

  • 2. A requirement of C-reactive protein greater than 3.0mg/dl to indicate systematic inflammation.

  • 3. Adjustments to criteria of organ system involvement to include addition of shock as a separate category and elimination of respiratory, neurologic and renal criteria.

  • 4. A new requirement on timing of a positive SARS-CoV-2 laboratory testing within 60 days of MIS-C illness.


  • Healthcare providers must report suspected cases of MIS-C by faxing the 2023 case report form to 717-772-6975 or to your local health department or by securely emailing the form to This email address is being protected from spambots. You need JavaScript enabled to view it..

  • Click HERE for the CASE REPORT FORM.  There is addtional case report guidance that can be referenced when completing the form. 

Date issued: 11/3/2022

The U.S. Food and Drug Administration (FDA) recommends that parents and caregivers do not use infant head shaping pillows intended to change an infant’s head shape or symmetry or claim to prevent or treat any medical condition. The FDA is not aware of any demonstrated benefit with the use of infant head shaping pillows for any medical purpose. The use of head shaping pillows can create an unsafe sleep environment for infants and may contribute to the risk of suffocation and death.

Infant head shaping pillows are not FDA-approved. The safety and effectiveness of these products have not been established for the prevention or treatment of flat head syndromeExternal Link Disclaimer (also known as positional plagiocephalyExternal Link Disclaimer or deformational plagiocephalyExternal Link Disclaimer), or the more serious condition where the developing infant’s skull bones join together too early (known as craniosynostosis).

Recommendations for Parents and Caregivers

  • Do not use infant head shaping pillows due to the risk of sudden unexpected infant death (SUID), inclusive of sudden infant death syndrome (SIDS), and suffocation and death.
  • If you own an infant head shaping pillow, throw it away; do not donate or give it to anyone else.
  • Be aware that infant head shaping pillows are not safe or effective for preventing or treating flat head syndrome or other medical conditions.
  • Be aware that, in most cases, flat head syndrome will go away on its own as an infant grows, it is not painful and it does not cause any developmental concerns.
  • If your infant has an unusual head shape, talk to your infant’s health care provider about management options. Know that the use of infant head shaping pillows may delay the necessary evaluation and management of harmless conditions, such as flat head syndrome, or more serious conditions, such as craniosynostosis.
  • To promote a safe sleep environment, the National Institutes of Health (NIH) and the American Academy of PediatricsExternal Link Disclaimer (AAP) recommend infants sleep on their backs in a bare crib on a flat (not inclined) surface without pillows, toys, soft objects, or loose bedding. The AAP guidelines regarding a safe sleep environment are intended to help reduce the risk of SUID as described in the NIH Safe to Sleep Campaign.
  • Learn more about safe sleeping environments by visiting FDA’s Recommendations for Parents/Caregivers About the Use of Baby Products.
  • If an infant in your care experiences an injury or adverse event when using a head shaping pillow, we encourage you to report it to the FDA and the manufacturer. Your report, along with information from other sources, can help the FDA identify and better understand the risks associated with medical devices.
  • Be aware that infant head shaping pillows do not treat craniosynostosis.

Recommendations for Health Care Providers

  • Discourage the use of infant head shaping pillows. Review this safety communication with your colleagues, care teams, parents, and caregivers who recommend, use, or may use infant head shaping pillows.
  • Educate your care communities, regarding the association of head shaping pillows with an unsafe sleep environment, which is associated with SUID, SIDS, and other causes of infant death, such as suffocation, that may occur with the use of head shaping pillows.
  • The FDA has cleared caps, helmets or head bands for use as cranial orthosis devices intended to improve cranial symmetry or shape in infants and toddlers from 3 to 18 months of age, with moderate to severe non-synostotic positional plagiocephaly. Some cranial orthosis devices are also intended for adjunctive use for infants from 3 to 18 months of age whose synostosis has been surgically corrected, but who still have moderate-to-severe non-synostotic positional plagiocephaly.
  • Improve awareness and understanding among your colleagues and care communities regarding a safe sleep environment for infants, and etiologies and associated management options for flat head syndrome.
  • If a parent or caregiver reports a problem with an infant head shaping pillow, advise them to discontinue its use and report it to the FDA and the manufacturer. Prompt reporting of problems can help the FDA identify and better understand the risks associated with medical devices.

Device Description

Infant head shaping pillows are typically small pillows, with an indent or hole in the center designed to cradle the back of an infant’s head while the infant lays face up, flat on its back. Sometimes these pillows do not have an indent or hole in the center and are rectangular shaped. These medical devices are marketed with claims to improve an infant’s head shape and symmetry and claim to prevent or treat flat head syndrome or other medical conditions. However, the safety and effectiveness of the use of these medical devices has not been demonstrated.

FDA Actions

The FDA is informing parents, caregivers, and health care providers of the risks associated with use of infant head shaping pillows. The FDA is working with stakeholders to increase awareness of the issue.

Recently, the FDA became aware of companies marketing infant head shaping pillows with claims for the prevention and treatment of flat head syndrome without FDA clearance or approval. The FDA has communicated our concerns about these promotional materials to these companies and will continue to monitor promotional materials and claims for these medical devices.

The FDA will keep the public informed if significant new information becomes available.

Reporting Problems to the FDA

If you experience adverse events associated with using an infant head shaping pillow, we encourage you to file a voluntary report through MedWatch, the FDA Safety Information and Adverse Event Reporting program. Health care personnel employed by facilities that are subject to FDA's user facility reporting requirements should follow the reporting procedures established by their facilities.

Date Issued: 10/28/2022

See full health advisory here. 


  • Respiratory syncytial virus (RSV) activity is increasing in Pennsylvania and nationwide, and levels are higher than usual for this time of year.
  • Clinicians and caregivers should be aware of age-related variations in the clinical presentation of RSV.
  • Clinicians should consider testing patients presenting with acute respiratory illness who have a negative SARS-CoV-2 test for non-SARS-CoV-2 respiratory pathogens, such as RSV and influenza. Real-time reverse transcription-polymerase chain reaction (rRT-PCR) is the preferred method of testing for respiratory viruses.
  • Clinicians should report laboratory-confirmed RSV cases to Pennsylvania Department of Health (PA DOH) through Pennsylvania's electronic reportable disease surveillance system,
    PA-NEDSS. Outbreaks or clusters of severe respiratory illness regardless of etiology should be reported to PA DOH or your local health department.
  • Administer prophylactic palivizumab to high-risk infants and young children per AAP guidance.
  • Healthcare personnel, childcare providers, and staff of long-term care facilities should avoid reporting to work while acutely ill – even if they test negative for SARS-CoV-2.
  • Encourage parents and caregivers to keep young children with acute respiratory illnesses out of childcare, even if they have tested negative for SARS-CoV-2.
  • Encourage all individuals to receive influenza and COVID-19 vaccines as soon as possible to protect themselves against those respiratory viruses and avoid associated complications.
  • Clinicians can review weekly updates to the NREVSS website and refer to surveillance data collected by local hospitals and health departments for information on RSV circulation
    trends in Pennsylvania.
  • If you have additional questions about this guidance, please contact DOH at 1-877-PAHEALTH (1-877-724-3258) or your local health department.

Date Issued: 12/20/2021

(CDC) Operational Guidance for K-12 Schools and Early Care and Education Programs to Support Safe In-Person Learning updated 10-5-22:

  • Removed the recommendation to cohort
  • Changed recommendation to conduct screening testing to focus on high-risk activities during high COVID-19 Community Level or in response to an outbreak
  • Removed the recommendation to quarantine, except in high-risk congregate settings
  • Removed information about Test to Stay
  • Added detailed information on when to wear a mask, managing cases and exposures, and responding to outbreaks
  • Click here to read guidance

Date Issued: 09/07/2021 - Revised 09/13/2022

Review the Pennsylvania Office of Child Development and Early Learning (OCDEL)'s suggestions COVID-19 Best Practices for Early Childhood Education (ECE

This page will help keep early childhood education (ECE) professionals informed on best practices for keeping children, staff and families safe and healthy as we continue to navigate the COVID-19 pandemic. 9-2022 update

The Centers for Disease Control and Prevention (CDC) breaks down the basics of Post- and Long-COVID - what to look for and how to manage it - here.

The Pennsylvania Office of Child Development and Early Learning (OCDEL) has released several policy announcements that pertain to the child care regulations for certified child care facilities. Child care providers can go to the Pennsylvania Key website to understand what is required to be in compliance with the established CCDF regulations and the Pennsylvania Child Care Regulations. Compliance dates for these announcements is April 29, 2022.

OCDEL released the policy announcement C-22-04, Updated Emergency Preparedness and Response Planning Regulations and Requirements for Child Care Facilities

The Pennsylvania Office of Child Development and Early Learning (OCDEL), Bureau of Early Learning Policy and Professional Development and Bureau of Certification has released Announcement C-22-06 Updated Health and Safety Pre-Service and One-Hour Training, effective Oct. 4, 2022. This Announcement provides details that all current child care staff who completed the previous health and safety pre-service training modules, prior to October 4, 2022, are required to complete the Pennsylvania Health and Safety Update 2022 Versión en español: Actualización de Salud y Seguridad de Pennsylvania 2022) by December 30, 2022. Beginning December 30, 2022, citations for non-compliance with any requirements to obtain health and safety professional development training updates required by OCDEL within the prescribed timeframe will be issued under 55 Pa. Code §3270.14, §3270.21, §3280.14, §3280.20, and §3290.18, all pertaining to compliance with “pertinent laws and regulations” and “general health and safety.” Also included is the list of previous versions of the health and safety pre-service training expiring Oct. 31, 2022.  [posted 10-6-22]

The Pennsylvania Department of Health issues COVID-19 and other health recommendations through the PA Health Alert Network (PA HAN). See link for current 2022 Health Alerts, Advisories and Updates.

The Health Alert Network is part of the Pennsylvania Department of Health's Public Health Emergency Preparedness and Response Program and was established under a cooperative agreement with the U.S. Centers for Disease Control and Prevention (CDC). PA HAN serves as a communication network among state and local public health agencies, health care providers, hospitals and emergency management officials. The information provided on the PA-HAN website is based upon recommendations from the CDC and other health organizations. If you are a public health professional, sign up for the Pennsylvania Health Alert Network (PA HAN). 

Contact your own healthcare provider for more guidance. If you have other questions, call your local health department or 1-877-PA-HEALTH (1-877-724-3258).

The American Academy of Pediatrics Parenting website has many COVID-19 resources to support families.  These include: Parenting in a Pandemic; Working and Learning; Getting Outside; Masks for Kids; New Baby Challenges; Disinfectant Safety and Breastfeeding.  

Every 3 Minutes a food allergy reaction sends someone to the emergency room and over 60 percent of food allergy reactions at school take place in preschools and child care facilities, notes the Food Allergy Research & Education’s (FARE) website. Keeping children with food allergies safe and healthy can present a special challenge in early care and education programs if you are not prepared.

  • Learn to modify early learning and school-age programs for a child with a food allergy. Plan for handling a food allergy response by reviewing the training presentations from Food Allergy Research & Education (FARE) such as Save a Life: Recognizing and Responding to Anaphylaxis”, “Keeping Students Safe and Included”, and “Navigating Early Childhood and Food Allergies”.
  • Use FARE’s Food Allergy & Anaphylaxis Emergency Care Plan, formerly the Food Allergy Action Plan, that outlines recommended treatment in case of an allergic reaction, is signed by a physician and includes emergency contact information. PA Keystone STARS Performance Standards LM.2.5 specifies policies relating to care plans for children with special needs including food allergies. Resources available include – “Tips for Managing Students with Food Allergies During a Shelter-in-Place Emergency”, “Tips for Field Trips”, “Tips for Cleaning”, “Tips for Non-Food Treats and Rewards”.
  • See the Centers for Disease Control and Prevention (CDC)’s Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs for additional recommended plans, practices, and procedures. 5-2021

Learn about strategies to manage children with challenging behaviors. Complete ECELS Managing Challenging Behaviors in Young Children Self Learning Module (SLM). This updated online module will help you promote mental health in young children. Explore risk factors for challenging behaviors and use tools to review behaviors related to development. Share resources to help children with challenging behaviors and their families. Identify policies to help prevent suspension and expulsion of children. The per person fee is $15.00 for each module submitted. Addresses Pennsylvania’s Pre-Kindergarten Learning Standards for Early Childhood Standard Areas 16.1-3

Use the following to share facts, credible information and updates from the Pennsylvania Department of Health Website

Human coronaviruses are a family of viruses that commonly cause mild to moderate illness like the common cold.  A new human coronavirus, called the 2019 Novel Coronavirus was discovered in Wuhan City, China in December 2019.  Symptoms of the 2019 Novel Coronavirus can include:

  • Fever
  • Cough
  • Shortness of breath

Use these additional credentialed sources to share information and updates with families and staff:

Stay vigilant about infection control practices in your program to reduce spread of all common illnesses. Implement the daily health check recommended in Caring for Our Children Standard

Motor vehicle crashes are a leading cause of death for children. The latest research from the National Highway Traffic Safety Administration (NHTSA) shows that 46% of car seats are misused. The best way to reduce crash fatalities among children is to always select a car seat, belt-positioning booster seat, or lap and shoulder seat belt based on the child’s age and size. Correctly installing a car seat and proper adjustment and fit of the harness or seat belt will improve a child’s safety when traveling. Data from crashes that occurred in 2020 found that more than a third of the children ages 12 and younger who died in cars, pickup trucks, vans, and SUVs were unbuckled. Never let children ride unbuckled—the consequences could be devastating. For information on achieving correct car seat use, attend a car seat check event, follow these and the manufacturer's instructions.

The single most effective way to protect children, and all vehicle occupants, is to correctly buckle them in a car seat, booster seat, or seat belt that is appropriate for their age and size. Car seat check events provide hands-on guidance on the correct selection, installation and use of the appropriate car seat, booster seat, or seat belt based on a child’s age, weight, height, and developmental needs. To locate a car seat check/fitting station click here. Car seat check events are also listed at under Events. If caregivers click ‘Fitting stations’ they can search by county for a car seat technician near them.

Best practice is for all vehicle passengers to be secured in a car seat, belt-positioning booster seat, or seat belt that is appropriate for their size. Parents and caregivers are role models for children and by wearing a seat belt, children learn the importance of buckling up. The National Highway Traffic Safety Administration has found when a driver is buckled, children are restrained 92% of the time and conversely when the driver is unbuckled, children are restrained about 68% of the time.

From PA Traffic Injury Prevention Project, PA Chapter - American Academy of Pediatrics 9-2022